Search

Since December 2019, digital health applications (DiGA) have been included in standard care in Germany and are therefore reimbursed by the statutory health insurance funds to support patients in the treatment of diseases or impairments. There are 48 registered DiGA listed in the directory of the Federal Institute of Drugs and Medical Devices (BfArM), mainly in the areas of mental health; hormones and metabolism; and muscles, bones, and joints. In this article, the "Digital Health" specialist group of the German Informatics Society describes the current developments around DiGA as well as the current sentiment on topics such as user-centricity, patient and practitioner acceptance, and innovation potential. In summary, over the past three years, DiGA have experienced a positive development, characterized by a gradually increasing availability of various DiGA and coverage areas as well as prescription numbers. Nevertheless, significant regulatory adjustments are still required in some areas to establish DiGA as a well-established instrument in long-term routine healthcare. Key challenges include user-centeredness and the sustainable use of the applications., (© 2023. The Author(s).)

Background: A child's attention deficit hyperactivity disorder (ADHD) is associated with strain for the parents. In turn, psychosocial parental strain is associated with higher probabilities for the occurrence of inattention/hyperactivity symptoms (IHS) in their children. The aim of this paper is to assess the association between parental strain, IHS, and a parent-reported ADHD diagnosis of the children., Methodology: Based on data from n = 4596 participants of the KiGGS cohort (wave 2: 2014-2017), the type and extent of parental strain was set in relation to IHS and an ADHD diagnosis of the child in cross-sectional analysis. Frequencies, means, beta coefficients, and odds ratios adjusted for sex, age, socioeconomic status, and migration background are reported., Results: In individual consideration, a greater number of parental strains were associated with IHS than with an ADHD diagnosis. In a multivariate analysis, financial worries and parenting problems/conflicts with the children were significant predictors of IHS and an ADHD diagnosis, respectively. In addition, four or more types of parental strain were associated with a higher likelihood of both IHS and an ADHD diagnosis., Discussion: Financial and child-rearing strain are relevant to parents of children with IHS and an ADHD diagnosis. Interrelationships between parental stress and a child's IHS or an ADHD diagnosis can be assumed. To relieve their burden, prevention can either aim at improving the situation of ADHD-affected families or at improving the family's handling of the child's ADHD., (© 2024. The Author(s).)

The interdisciplinary care of children and adolescents with mental disorders requires services from various German codes of social law and-within the medical care system-enclosing inpatient and outpatient services. The increasing demand, the increase in severity of disorders, and the general shortage of staff in social services put pressure on the structures of the interdisciplinary service networks resulting in long waiting periods, long distances, and regionally insufficient care. The medical field of child and adolescent psychiatry and psychotherapy (CAPP) plays the central and coordinating role within the cooperative care for children and adolescents with mental disorders. The CAPP is in clear need of reforms; however, these are markedly different from the reform needs of the German somatic medical care system and differ substantially from those of the (adult) psychiatry, psychotherapy, and psychosomatics disciplines. This discussion paper describes the reform requirements, the specifics of the CAPP structures, and suggestions to overcome sectors of service provision, enhance networking, intensify telemedicine, and develop evidence-based prevention and early recognition of child mental disorders., (© 2024. The Author(s).)

Introduction: Affective impairments/disorders are one explanation as to why adolescents exhibit externalizing problem behavior (rule-breaking and dissocial behavior). Impaired affect is a core feature of callous-unemotional traits (CU traits). CU traits are composed of three factors: Callousness (lack of empathy and remorse), Uncaring (indifferent attitude toward task performance and the feelings of others), and Unemotional (superficial or flattened affect). Externalizing problem behaviors mostly occur in groups during adolescence. Therefore, it is important to consider the relationship between CU traits and externalizing problem behaviors that are exhibited explicitly in collaboration with or in the presence of friends. This perspective has been lacking in research on CU traits. The present study aims to fill this research gap., Methods: Self-report data were collected between June 2021 and March 2023 from N = 169 adolescents (54% female; M = 14.95 years) using a set of questionnaires that could be completed online or as a paper-pencil version. In addition to CU traits (ICU) the set of questionnaires included assessments of rule-breaking and dissocial behavior with friends (CBCL: YSR 11-18 R)., Results: Only the subscale Callousness contributes to the explanation of externalizing problem behaviors with friends (6% variance explained)., Discussion: The results indicate that the three factors of CU-traits should be considered separately. In addition, when examining externalizing problem behavior, one should consider whether it is exhibited alone or together with or in the presence of friends. Limitations of the study, ideas for further research, and practical implications are discussed., (© 2024. The Author(s).)

The nexus between urban planning and public health acknowledges the importance of creating cities that contribute to their residents' physical, mental, and social well-being. The Healthy Cities movement underlines that community participation and intersectoral work are important to create sustainable, equitable, and healthy cities.Several theoretical and practical participatory approaches form the foundation for participation in public health and urban planning. Growing digitalization has significantly transformed how participation is conducted in various fields. Digital technologies not only play a large role in daily life, but they have opened more opportunities for individuals to interact, share, and collaborate in the planning and design of cities.This article explores how digital technologies enable participation among residents and stakeholders in order to support the health-oriented planning of cities and neighborhoods. From the selective case studies presented in the paper, it can be ascertained that digital technologies can support various forms of participation by enabling different levels of engagement as well as both one-way and two-way interactions. Some forms of engagement can be supported entirely within digital platforms. However, in the case of higher engagement, which requires deeper insights into the problems and the codevelopment of solutions, other nondigital formats and traditional methods such as follow-up workshops and focus group discussions are necessary to complement the digital form of participation., (© 2024. The Author(s).)

The burden of mental diseases is enormous and constantly growing worldwide. The resulting increase in demand for psychosocial help is also having a negative impact on waiting times for psychotherapy in Germany. Digital interventions for mental health, such as interventions delivered through or with the help of a website (e.g. "telehealth"), smartphone, or tablet app-based interventions and interventions that use text messages or virtual reality, can help. This article begins with an overview of the functions and range of applications of digital technologies for mental health. The evidence for individual digital forms of interventions is addressed. Overall, it is shown that digital interventions for mental health are likely to be cost-effective compared to no therapy or a non-therapeutic control group. Newer approaches such as "digital phenotyping" are explained in the article. Finally, individual papers from the "Leibniz ScienceCampus Digital Public Health" are presented, and limitations and challenges of technologies for mental health are discussed., (© 2024. The Author(s).)

This article addresses the question of how climate change may affect health and to what extent real-world data can contribute to research in this topic area. Climate change is altering the environmental and living conditions of humankind, and has thus also become a relevant health problem. The increase in extreme weather events, changes in exposure to UV and air pollution, and the climate-associated spread of allergens or novel pathogens are significantly changing the spectrum of diseases and the need for medical care in the population. However, in Germany, only few findings on the consequences for the healthcare system and on particularly affected population groups exist so far. Real-world data (primary data, register data, and administrative data) in combination with environmental exposure data and other relevant data (e.g., socio-economic data) have the potential to significantly advance research on the health consequences of climate change. This paper identifies changes in environmental and living conditions and associated health risks. It describes the databases that are generally available for analysing health effects of climate change. A concrete example is used to show how individual health data (in this case claims data of the statutory health insurance), environmental exposure data and other data can be successfully combined. Finally, the article offers a comprehensive overview of open research questions that can be answered with real-world data., (© 2024. The Author(s).)

Real-world data is increasingly becoming the focus of healthcare research in the context of digitization. The timely availability of large amounts of data gives hope that research questions can be answered quickly without additional data collection and that a direct benefit for the care of people can be achieved. Especially in acute care situations, such as heat waves or a pandemic, this can be crucial. But real-world data depend quite significantly on the quality and intent of data collection. It is also influenced by determinations on semantic and syntactic standards that are made for primary data - often considering different use cases. In the context of different initiatives on national and international levels, a holistic view on data collection and evaluation and a regular feedback mechanism between data evaluation and specifications for the collection should be established. By including requirements for secondary data evaluation in the definition processes for data collection, the informative value of the data for research can be increased in the long term.In this discussion paper, the activities for standardized data collection in the context of the digitization initiatives and the corresponding European approaches are first presented. After outlining the effects of these activities on the possibilities and difficulties of data consolidation for the analysis of real-world data, the article calls for an ongoing discourse between the different areas., (© 2024. The Author(s).)

The increasing digitization of the healthcare system is leading to a growing volume of health data. Leveraging this data beyond its initial collection purpose for secondary use can provide valuable insights into diagnostics, treatment processes, and the quality of care. The Health Data Lab (HDL) will provide infrastructure for this purpose. Both the protection of patient privacy and optimal analytical capabilities are of central importance in this context, and artificial intelligence (AI) provides two opportunities. First, it enables the analysis of large volumes of data with flexible models, which means that hidden correlations and patterns can be discovered. Second, synthetic - that is, artificial - data generated by AI can protect privacy.This paper describes the KI-FDZ project, which aims to investigate innovative technologies that can support the secure provision of health data for secondary research purposes. A multi-layered approach is investigated in which data-level measures can be combined in different ways with processing in secure environments. To this end, anonymization and synthetization methods, among others, are evaluated based on two concrete application examples. Moreover, it is examined how the creation of machine learning pipelines and the execution of AI algorithms can be supported in secure processing environments. Preliminary results indicate that this approach can achieve a high level of protection while maintaining data validity. The approach investigated in the project can be an important building block in the secure secondary use of health data., (© 2024. The Author(s).)

Background: Artificial intelligence (AI) is becoming increasingly important for the future development of hospitals. To unlock the large potential of AI, job profiles of hospital staff members need to be further developed in the direction of AI and digitization skills through targeted qualification measures. This affects both medical and non-medical processes along the entire value chain in hospitals. The aim of this paper is to provide an overview of the skills required to deal with smart technologies in a clinical context and to present measures for training employees., Methods: As part of the "SmartHospital.NRW" project in 2022, we conducted a literature review as well as interviews and workshops with experts. AI technologies and fields of application were identified., Results: Key findings include adapted and new task profiles, synergies and dependencies between individual task profiles, and the need for a comprehensive interdisciplinary and interprofessional exchange when using AI-based applications in hospitals., Discussion: Our article shows that hospitals need to promote digital health literacy skills for hospital staff members at an early stage and at the same time recruit technology- and AI-savvy staff. Interprofessional exchange formats and accompanying change management are essential for the use of AI in hospitals., (© 2023. The Author(s).)